Rosacea can be temporary or permanent, and typically follows a waxing and waning pattern with flare ups. The redness is caused by dilated blood vessels under the skin surface. Some forms of rosacea have accompanying sebaceous (oil) gland dysfunction that causes pustule formation.
Less common causes of rosacea include, an immune system reaction to the bacteria bacillus oleronius, an intestinal infection caused by h. pylori bacteria, and demodex mites (which we actually all have living on our skin).
When the flushed red skin of rosacea is accompanied by changes in skin texture, like bumpiness and roughness, a more severe form of rosacea may be present. The American Academy of Dermatology has categorized four types of rosacea:
- Erythematotelangiectatic Rosacea: The most basic form of rosacea, characterized by redness, flushing, and visible blood vessels.
- Papulopustular Rosacea: Facial redness plus pustules. Often confused with acne.
- Phymatous Rosacea: A variant of rosacea causing thickened, bumpy skin texture.
- Ocular Rosacea: A more severe form of rosacea which causes red and irritated eyes along with swollen eyelids. In some cases, if left untreated this can cause permanent eye problems.
Those with symptoms consistent with papulopustular or phymatous rosacea will most likely need professional interventions in addition to home care to manage their skin condition. Ocular rosacea, which causes eye inflammation may require prescription medication, such as an antibiotic.
The first step in rosacea treatment is determining what triggers flare-ups. Rosacea typically worsens when exposed to the sun, after eating spicy foods or drinking hot drinks, under stressful or emotional situations that raise your blood pressure, taking hot baths, and certain medications or cosmetics. Knowing what causes your rosacea flare ups can help with mitigating the severity. General skincare advice, like limiting sun exposure, applying sunscreen, and using products specially formulated for rosacea patients will also help.
When at home care isn’t cutting it, a professional cosmetic procedure can provide significant benefit. Laser Skin Resurfacing is a versatile option for treating different forms of rosacea. Gels and creams can help clear the pustules seen in papulopustular rosacea. Isotretinoin is a daily oral medication to treat cases of papulopustular and phymatous rosacea. Of note, in some severe cases the thick skin caused by phymatous rosacea may require surgical intervention.
In the case of ocular rosacea it is important to consult a medical provider when taking prescribed medication and eye drops to ensure appropriate treatment, and avoid future eye problems.
The decision to pursue treatment is usually dependent on individual patient preferences, and the severity of their symptoms. For some men and women, home care and lifestyle changes are sufficient to control their rosacea.
In more stubborn or severe cases, professional interventions may be necessary to reduce facial redness, prevent pustules, and limit changes to skin texture. For any concerns related to the eye, always consult with a medical provider to ensure you are receiving appropriate treatment.
The decision to pursue treatment for rosacea is unique to each individual. For those desiring a clearer, more uniform facial skin aesthetic, professional treatments can provide a significant and lasting result. For cases of severe rosacea, the impact on quality of life can be frustrating and upsetting, which may be a motivating factor in pursuing a treatment. Regardless of your motivation, pursuing professional rosacea interventions can significantly reduce your symptoms.